Back to Table of Contents | May 2010

MMA News Now

MMA Supports New GAMC Plan

The MMA has taken a stand in favor of a DFL-sponsored plan released in April that would result in $1.136 billion in new federal payments to the state over three years to provide health insurance coverage for GAMC enrollees and improve reimbursement levels for providers who treat them.

Earlier this session, lawmakers introduced a proposal (H.F. 3713) that would take advantage of an early opt-in provision in the federal health care reform law that would extend Medical Assistance coverage to adults earning less than 75 percent of poverty, provided the state matches the federal dollars it receives. The bill’s chances looked slim after the net cost to the state in the next biennium was estimated to be as much as $881 million.

That number was as large as it was in part because the state also needed to offset an anticipated shortfall in the Health Care Access Fund (HCAF), which collects revenues from the state’s 2 percent provider tax and helps pay for the MinnesotaCare subsidized insurance program.

However, if the state does not shore up the HCAF, then the forecasted cost would drop to $64 million over three years, according to a new fiscal note from the Office of Budget and Management. This represents only the cost to the state of insuring people with incomes below 75 percent of poverty.

MMA President Benjamin Whitten, M.D., testified in favor of the proposal before the House Health and Human Services Finance Committee. Whitten told lawmakers that the MMA supports the repeal of the recently passed GAMC law, which maintains coverage for adults with incomes less than 75 percent of poverty but includes severe payment cuts to providers and restricts access to outpatient services.

Whitten testified that the MMA supports shifting GAMC enrollees to the Medical Assistance program instead of implementing the GAMC fix. He also said that the MMA opposes any long-term use of HCAF revenue to finance Medical Assistance.

Sign Up to Stop the Meltdown

The MMA has ramped up its efforts to push for a permanent fix to Medicare’s sustainable growth rate (SGR) formula.

In April, it joined a national campaign to gather 1 million signatures to Stop the Medicare Meltdown. The MMA set up a website where members and others can sign a petition and is encouraging physicians to do so. The MMA has also put together a flier that physicians may post in their offices or give to patients to encourage them to sign the petition as well.

The Texas Medical Association launched the campaign April 5. Within days of the launch, 50 state medical societies, including the MMA, and more than 15 specialty societies joined the petition drive.

Visit www.mmaonline.net/medicaremeltdown to sign the petition.

Minnesota Launches POLST Effort

The MMA issued a press release last month encouraging physicians and patients to complete or discuss a Provider Orders for Life Sustaining Treatment (POLST) form, as part of National Healthcare Decisions Day April 16.

More specific than an advance directive, POLST is a medical order based on a person’s wishes for their final days. It addresses resuscitation, intubation, use of emergency medical services, medical nutrition, and use of antibiotics. The POLST form is intended to travel with the patient whenever their care setting changes and should be kept in a visible place. It is signed by the patient’s health care provider.

The Minnesota POLST form is the result of years of work by the MMA Ethics Committee and, more recently, by a statewide workgroup organized by the MMA. Edward Ratner, M.D., chair of the MMA workgroup and a University of Minnesota ethicist, recommends the POLST form be used by all patients with life-threatening or terminal health conditions. It is intended to supplement, not serve as a substitute for, an advance directive.

The POLST form is available online at www.polstmn.org. It has been endorsed by the MMA and the Minnesota Emergency Medical Services Regulatory Board.

It’s All About Relationships

Editor’s Note: In March, former MMA president G. Richard Geier, M.D., and Roy Yawn, M.D., president of Olmsted Medical Center, took advantage of the MMA’s offer to arrange a personal day at the Capitol. Dr. Geier graciously agreed to describe his experience.

Advocacy for physicians and patients at the state level is one of the most important functions of the Minnesota Medical Association. So the fact that our Day at the Capitol on February 9 was canceled by a snowstorm was a major disappointment. It was also a case of deja vu, as I had missed Day at the Capitol several years ago because of the weather. In that instance, I arranged to have a member of the MMA legislative staff lead me on a private tour a few weeks later. That day, we visited with six Rochester-area legislators over two hours and met a couple of others in the hallway. The experience was very efficient and productive.

With that in mind, I called the MMA office and spoke with Dennis Gerhardstein, the MMA’s manager of physician outreach, about setting up a personal Day at the Capitol for myself and Roy Yawn, M.D., president of the Olmsted Medical Center. The afternoon of March 11, Roy and I met Dennis and Dave Renner, the MMA’s director of state and federal legislation, near the Capitol rotunda. Dave briefed us on issues that were changing by the day. Dennis then took us to meetings with my senator, Dave Senjem (R-Rochester), and my representative, Tina Liebling (DFL–Rochester), and with Roy’s senator, Ann Lynch (DFL-Rochester), and his representative, Kim Norton (DFL-Rochester).

We discussed two issues during these meetings. The first was health care reform—in particular, a bill that would change the implementation timeline for provider peer-grouping. Rep. Lynch was carrying the bill in the House. The other was the GAMC situation. At that time, a compromise had just been reached that would allow the program to continue, but serving people who earn less than 75 percent of poverty and significantly cutting payments to physicians. As bad as it was, it seemed a better solution than eliminating the program altogether.

We also saw Rep. Thomas Huntley (DFL-Duluth), chair of the Health Care and Human Services Finance Division, who has been a valuable MMA ally in health care reform discussions and in the passage of the 2008 Freedom to Breathe Act. I thanked him for his support, and he shared information about a possible federal solution to the GAMC problem.

We watched the end of the Health Care and Human Services Policy and Oversight Committee meeting and afterward had a chance to greet Rep. Diane Loeffler (DFL-Minneapolis), whom I had served with on an insurance reform workgroup in 2008.

We could see that the MMA lobbyists are well-respected at the Capitol but also that their work is made easier and more effective by the participation of individual physicians. We can provide real-life examples of the problems they are trying to solve. The better we know our lawmakers, the more effective we become. Taking time to visit legislators at the Capitol or to meet them at home helps; getting involved in their election campaigns is even better. —G. Richard Geier, M.D., former MMA President